Vol.:(0123456789) 1 3 Medical Oncology (2018) 35:157 https://doi.org/10.1007/s12032-018-1222-4 ORIGINAL PAPER Autotaxin is a novel molecular identifer of type I endometrial cancer Antonio Mazzocca 1  · Luca Maria Schönauer 2  · Rosalba De Nola 2,3  · Antonio Lippolis 2  · Teresa Marrano 2  · Matteo Loverro 2  · Carlo Sabbà 1  · Edoardo Di Naro 2 Received: 10 September 2018 / Accepted: 25 October 2018 / Published online: 29 October 2018 © Springer Science+Business Media, LLC, part of Springer Nature 2018 Abstract Endometrial cancer is the most common cancer of the female genital tract in Western Countries, with an incidence of 150.000 new cases/year. Despite high incidence, little is known about the molecular pathogenesis of this tumor. Phospholipids including lysophosphatidic acid (LPA) are involved in proliferation and dissemination of cancer. LPA is a potent bioactive phospholipid synthesized by autotaxin (ATX) through its lysophospholipase D activity. Recent evidence suggests that the ATX/LPA signaling axis plays a role in endometrial cancer. We carried out a prospective study involving two groups of patients classifed in accordance to hysteroscopic-guided biopsy. Patients with histological diagnosis of endometrial cancer were enrolled into group one, whereas control patients with pelvic organ prolapse were assigned group two. Both groups underwent hysterectomy, with either open or laparoscopic surgery. After uterine extraction, a second endometrial biopsy was performed to collect tissues. Real-Time PCR was performed to evaluate ATX gene expression in collected tissues. Sta- tistical analysis including unpaired two-way or one-way Student’s t test and ANOVA was performed. We found ATX gene expression signifcantly higher in neoplastic endometrium compared with normal tissue (P value = 0.0002). In particular, the expression of ATX was signifcantly elevated in type I endometrial cancer (i.e., endometrioid histotype) compared to type II, in premenopausal women and in patients afected either by obesity (BMI > 30) or diabetes. We propose ATX as a novel potential biomarker particularly implicated in the pathobiology of type I endometrial cancer. Also, we propose ATX as a useful theranostic target in endometrial cancer. Keywords Autotaxin (ATX) · Endometrial cancer · Lysophosphatidic acid (LPA) · Biological marker · Obesity Abbreviations ATX Autotaxin LPA Lysophosphatidic acid RT Reverse transcription PCR Polymerase chain reaction BMI Body mass index PTEN Phosphatase and tensin homolog PIK3CA Phosphatidylinositol 3-kinase KRAS Kirsten rat sarcoma virus p53 Protein 53 HER-2/neu Human epidermal growth factor receptor 2/ proto-oncogene Neu p16 Protein 16 PLD Phospholipase D RNA Ribonucleic acid DNA Deoxyribonucleic acid GAPDH Glyceraldehyde 3-phosphate dehydrogenase gene SEM Standard error of the mean SMB Somatomedin B-like ENPP 2 Ectonucleotide pyrophosphatase/phosphodi- esterase type 2 PLA2 Phospholipase A2 LPARs Lysophosphatidic acid receptors * Antonio Mazzocca antonio.mazzocca@uniba.it 1 Interdisciplinary Department of Medicine, University of Bari School of Medicine, Piazza G. Cesare, 11, 70124 Bari, Italy 2 Interdisciplinary Department of Medicine, Gynaecology and Obstetrics Clinic, University of Bari School of Medicine, Piazza G. Cesare, 11, 70124 Bari, Italy 3 Department of Tissues and Organs Transplantation and Cellular Therapies, D.E.O.T, School of Medicine, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy